Inappropriateness and variability of antibiotic prescription among French office-based physicians.
OBJECTIVE
To describe oral antibiotic prescription in the community.


METHODS
Audit of anti-infective prescribing in office-based medical practice.


METHODS
Center of France, in the Loiret, a 600,000 inhabitant administrative division.


METHODS
Clinical hypothesis and antimicrobial drugs used as well as daily doses and durations of treatment.


RESULTS
Respiratory tract infections with a presumed viral etiology accounted for 36% of prescriptions. In children, a high percentage of antibiotic prescriptions were underdosed as compared to clinical recommendations, particularly in acute otitis media. The variability of the daily dose was high, with coefficients of variation over 40% in acute otitis media or acute tracheobronchitis. Whatever the clinical hypothesis, the duration of treatment was close to 8 days. In acute otitis media, the coefficient of variation was 14%, the lowest for all diagnoses.


CONCLUSIONS
Our investigation identified two main areas for improving antimicrobial drug prescribing: (1) reduction of useless prescriptions in respiratory tract infections with a presumed viral etiology, and (2) increasing the prescribed daily dose of antimicrobials to the recommended levels.
Guillemot
D
D
Institut National de la Santé et de la Recherche Médicale U21, Villejuif, France.
Carbon
C
C
Vauzelle-Kervroëdan
F
F
Balkau
B
B
Maison
P
P
Bouvenot
G
G
Eschwège
E
E
D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002648:Child; D011307:Drug Prescriptions / Q000592:standards*; D004363:Drug Utilization; D005260:Female; D005602:France; D019983:Guideline Adherence; D006801:Humans; D008297:Male; D008485:Medical Audit; D009819:Office Visits; D010033:Otitis Media / Q000382:microbiology; D010818:Practice Patterns, Physicians' / Q000592:standards*; D012141:Respiratory Tract Infections / Q000188:drug therapy / Q000382:microbiology; D011795:Surveys and Questionnaires
D000900:Anti-Bacterial Agents